Health Insurance For Low-Income
The Department of Health and Mental Hygiene (DHMH) provides Medicaid coverage to individuals financially eligible or medically needy. HealthChoice is the name of Maryland’s statewide mandatory managed care program.
Eligible Medicaid participants must enroll in a Managed Care Organization (MCO), which is a healthcare organization that provides services to Medicaid recipients in Maryland. Once enrolled, a Primary Care Provider (PCP) must be selected to oversee their medical care.
There are currently 8 MCOs participating in HealthChoice:
Maryland Medicaid Plan Options
Maryland has several Medicaid programs available for its residents based on their age, health situation, and income levels.
Children’s Health Program (MCHP)
The Maryland Children’s Health Program (MCHP) gives full health benefits for children up to age 19 and is provided through a variety of Managed Care Organizations (MCOs).
Healthy Kids/EPSDT Program
The Maryland Healthy Kids/EPSDT Program promotes access to and ensures availability of quality healthcare for children, teens, and young adults less than 21 years of age. The goals of the program are early identification and treatment of health problems before they become serious and costly to treat.
Maryland Medical Assistance Family Planning Program
The Family Planning Program provides medical services to eligible women under 51 years old and for women who lost their Medicaid coverage after pregnancy. It provides limited coverage for visits to a doctor, nurse practitioner, nurse midwife, or clinic for birth control.
Maryland Children’s Health Program (MCHP)
The CHIP program for Maryland is called MCHP and it provides coverage for uninsured children under age 19 if their family income is no more than 200% of the Federal Poverty Level (FPL).
Additional Coverage Groups
Outside of the traditional groups generally used for Medicaid coverage, Maryland Medicaid also covers the following scenarios:
Aliens
Medicaid eligibility can be available for a non-U.S. citizen in Maryland if they have a Lawful Permanent Residence (LPR), a refugee, and a few other specific exceptions.
Aged, Blind, or Disabled (ABD) Persons
Medicaid coverage may be granted to individuals that receive supplemental security income or if they are qualified as being elderly/disabled.
Institutionalized Persons – Long Term Care
Long term services and support is available to adults with disabilities that need both medical care and non-medical living support to assist with normal daily tasks. Medicaid LTSS for adults with disabilities covers care provided at home and in community settings, as well as in health facilities like hospitals and nursing homes.
Additional Medicaid Programs
The state of Maryland has also made the following programs available for their residents:
Women’s Breast and Cervical Cancer Health Program (WBCCHP)
This program covers uninsured or underinsured women at specific income levels who need screenings for breast or cervical cancer. The program also provides diagnostic services and follow-up when an abnormality is found.
Kidney Disease Program
The Kidney Disease Program (KDP) provides reimbursement for Maryland residents who receive dialysis treatment for approved services that may be required as a direct result of end-stage renal disease (ESRD).
Program of All-Inclusive Care for the Elderly (PACE)
The Program of All-inclusive Care for the Elderly (PACE) is a care model for acute and long-term care individuals age 55 and older that meet state specific criteria for nursing home care placement. The goal of PACE is to maximize the participant’s autonomy and ability to reside in their community, while receiving quality care at lower cost relative to the Medicare, Medicaid, and traditional private pay programs.
Home and Community-Based Services (HCBS)
Maryland Medicaid Long Term Services and Supports provides opportunities for children, older adults or the disabled to continue participating in their community activities. Services range depending on the situation, but the goal is to improve the qualify of life of the entire family.
Medicare Costing Savings Programs
The Maryland Medical Assistance Program, also known as "Medicaid", is a Federal and State funded program providing medical and health-related services for eligible Maryland residents.
The Executive Office of Health and Human Services (EOHHS) administers the Medicaid program to provide health insurance for low-income families with children, pregnant women, senior citizens, people with disabilities or special needs, and other residents struggling to access affordable healthcare.
Maryland Medicaid FAQs
- What is Medicaid?
Medicaid is a state funded insurance that that provides coverage to low income families, pregnant women, newborns, and children that may not be able to afford to purchase their own care.
- Who is eligible for Medicaid?
The following individuals are eligible for Maryland Medicaid:
- Children 0 - 18 with a household income less than 317% of the Federal Poverty Limit (FPL);
- Pregnant women with a household income less than 250% of the FPL;
- Adults with a household income less than 133% of the FPL.
- How do I find out if I am eligible for Medicaid?
To find out if you are eligible for Medicaid, you must fill out an application for Medicaid or CHIP. You may fill out an application at any time of the year. See more on Medicaid.
- Will Medicaid cover my children?
Your household income level will determine if your child or children can be covered by Medicaid.
- What is CHIP?
CHIP is a program that supports children in families that cannot afford private health insurance, but whose household income is too high to qualify for Medicaid.
- Does Medicaid satisfy the health insurance requirement?
Yes, Medicaid will satisfy the Affordable Care Act (Obamacare) health insurance requirement for the covered individuals.
- What information and documents should I have when I'm signing up for Medicaid?
Depending on the Medicaid program being applied for, you will need the following: Identity, Social Security, proof you live in Maryland, proof of income, proof of medical costs, and bank account information.
- How does Obamacare work with Medicaid?
Because of Maryland's Medicaid eligibility requirements, Obamacare does not impact people who qualify for Medicaid and vice versa. As such, tax credits are only available for people who are not eligible for other plans.
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